Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/42—Gynaecological or obstetrical instruments or methods
  • A61B17/44—Obstetrical forceps
  • A61B17/442—Obstetrical forceps without pivotal connections, e.g. using vacuum

Definitions

• the present invention relates to an instrument for extracting fetuses by the natural genital route, that is to say by the vaginal route.
• the forceps is a pair of tweezers dating back to Roman times but whose modern forms date from the 16th century.
• the forceps with crossed branches, articulated together and whose "jaws” or “spoons” of the forceps have a cephalic curvature adapting to the fetal head and a pelvic curvature adapting to the maternal pelvic floor, include traction means spoons, the best of which are included in the TARNIER forceps.
• the parallel branch forceps developed by DEMELIN eliminates the joint problems posed by crossed branch forceps.
• the non-crossed branches, articulated by a screw, at the level of the sleeves which extend the spoons, which can be tightened at will, thus protecting the fetal head, have been replaced by forceps with parallel branches , joined by a transverse branch and on which lakes can be fixed.
• the two symmetrical spatulas include a full spoon with facial curvature and pelvic curvature, and a reet ⁇ line handle having at its free end notches for receiving the fingers of the birth attendant; their purpose is to make the fetal head reproduce movements close to physiological movements, but respecting its mobility.
• the fetal extraction suction cups consist of three main elements: a gripping system, a traction device and a vacuum generator.
• the gripping system consists of a cup, or metal suction cup, of suitable diameter to have sufficient adhesion.
• the traction device consists of a metal plate kept at a slight distance from the suction cup and in the center of which is fixed a metal chain which runs inside a flexible rubber tube itself connected to the orifice external of the suction cup and at the opposite end of which fits a cruciform metal handle, one of the hollow branches of which allows the introduction of a rod engaging the traction chain.
• the vacuum generator consists of a vacuum pump equipped with a pressure gauge and operating by hand.
• Dr. John EVANS CHICAGO, mid-19th century
• Dr. John EVANS formed of two parallel steel branches, with a curve to go around the bottom of the sacrum and a joint allowing relative mobility near the end of the curved segment, while the parallel bars were held together by a flat clasp, on the handles, during the introduction of the curved ends into the pelvis; a net of silk ribbon intended to enclose the fetal head was attached to the curved end branches. After introduction, the clasp was removed, the branches were separated and one of them was passed to the opposite side of the pelvis, so as to encircle the fetal head in the net.
• the instruments for extracting the fetal head currently in use, have a certain number of drawbacks: they must be used by birth attendants experienced in their handling to avoid any injury consequences for the child and / or the mother. which they are however not always able to avoid, because of the rigid metallic structure of the instruments used and their principle of operation.
• the present invention has therefore given itself the aim of providing an apparatus for extracting fetuses, in particular human, by the natural maternal genital tract, which better meets the needs of the practice than the instruments proposed in the prior art, in that it ensures better grip of the fetal head without traumatic risks for both the mother and the child, in that it avoids any friction by isolating the head of the fetus in its downward movement, from the soft parts of the basin and in that its design is such that it can be produced at a cost price low enough to allow its use for "single use", thus avoiding the sterilization operations to which these kinds of instruments must usually be subjected.
• the subject of the present invention is an apparatus for extracting fetuses by the natural maternal genital tract, which is characterized in that it comprises in combination: a carcass constituted by a plurality of flexible rods arranged substantially in the shape of a corolla, integral, at one of their ends, a hollow tubular sheath and at their free opposite end, of a reticulated structure of flexible material which extends inside the aforementioned corolla and the bottom of which is made integral with a suitable traction member, which cross-linked structure of flexible material consists of two networks nested one inside the other, one of which is a network with blocked meshes and the other of which is a network with free meshes, the braids which compose the network with free meshes of the reticulated structure comprising at their lower end, ie at their end which extends freely inside the aforementioned corolla, traction strands fixed at said end and which terminate at their opposite end to their end fixed to the reticulated structure, in an anchoring core capable
• the traction strands are guided in the above-mentioned tubular sheath.
• the traction member comprises a cage or the like intended to receive the abovementioned anchoring core, on a part of which is mounted a movable sleeve and whose l 'opposite end to that on which the sleeve is mounted carries a pull handle.
• the sleeve is movably mounted on the end part of the anchoring cage oriented towards the hollow tubular sheath of the extraction device.
• said end part is provided with a thread corresponding to the internal thread which is also provided with the aforementioned sleeve.
• the sleeve cooperates with a stop integral with the above-mentioned tubular sheath.
• FIG. 1 is a side elevational view of an appliance for extracting the fetal head, in accordance with the present invention.
• Figure 2 is an enlarged view of the flexible cross-linked structure and the semi-rigid corolla to which it is fixed at one of its ends.
• the apparatus for fetal expulsion by the natural maternal genital tract comprises a plurality of rods 1 made of an appropriate material giving them a certain resilience, metal, plastic material, etc. These rods 1 are fixed at one of their ends to a hollow tubular sheath 2, while at their free ends 3 is fixed a cross-linked structure 4 which extends inside the structure substantially in the shape of a corolla determined by the union of the rods 1 secured at their ends lower than said sheath 2.
• the dimensions of the crosslinked structure 4 are sufficient to allow it to enclose the head of the fetus during fetal extraction operations.
• Traction strands 5 are fixed to the lower part of the crosslinked structure 4 and are guided in the sheath 2. It is the traction of these strands 5 which allows the operation of the apparatus according to the invention and the expulsion of the fetus.
• Said traction member comprises, in addition to said anchoring cage 7, a sleeve 8 and a pull handle 9.
• the sleeve 8 is mounted movably on the end portion 10 of the anchor cage 7 oriented towards the sheath 2 above; the mobility of the sleeve 8 is given to it by providing the end portion 10 of the anchoring cage 7 with a thread which cooperates with a corresponding internal thread which is provided with the sleeve 8.
• the pull handle 9 is fixed to the end of the anchoring cage 7 opposite to that which carries the thread, 10. The movement of the sleeve is limited by the provision of an abutment collar 11 fixed on the sheath 2.
• the traction member is easy to associate with the expulsion device proper, which consists of the corolla 1, the cross-linked structure 4 with the traction strands 5 and the sheath-handle 2.
• the crosslinked structure made of flexible material, consists of two networks which are closely nested one inside the other, one of which is with locked meshes 12, and the other of which is formed by a network with free meshes 13
• the braids which form the network 12 and the network 13 are fixed together at each of the free ends of the rods 1 which form the aforementioned corolla, and the reticular structure 4, formed of these two joint networks 12 and 13, extends to the inside said corolla. While the braids of the two networks are fixed to the free ends of the stems 1 of the corolla, only the braids of the free-mesh network 13 are made integral, without removal, from the traction strands 5.
• the flexible material from which the crosslinked structure 4 is made is advantageously, but not limited to, an appropriate textile material or a synthetic material or even an appropriate flexible material.
• the rods 1 are advantageously, but not limited to, formed of preferably semi-rigid metallic wires and affected with a certain resilience, or of plastic wires meeting the same criteria. It is advantageous to coat said rods 1 with a material facilitating the sliding of the device inside the maternal genital tract, such as "TEFLON" in particular.
• the operation of the fetal extraction device is as follows: when the conditions of the expulsion phase are met and it is desired to shorten fetal suffering and / or expulsion efforts or to compensate for the cessation or absence of expulsion efforts, assistance is obtained from the fetal expulsion device according to the present invention, by proceeding as follows: the "applicator" part of the device , which includes the corolla to which the crosslinked structure 4 is maneuvered by the traction strands 5 and which is itself fixed to the sheath 2 by the lower ends of the rods 1 which compose it, is introduced through the maternal genital tract until contact with the fetal head, by exerting a slight traction on the traction strands 5 preferably joined in a 5 'cord, in order to reduce the diameter of the applicator.
• the traction exerted on the cord 5 ′ is then released and the rods 1 are engaged around the fetal head.
• the traction unit (which consists of the sleeve 8, the anchoring cage 7 and the traction handle 9) is then assembled to the gain handle 2 of the applicator, by simultaneously introducing the traction cord 5 'and the anchor core 6 in the anchor cage 7, then the sleeve 8 is screwed onto the thread 10 of the anchor cage 7 and it is brought into contact with the abutment flange 11 mounted on the sheath-handle 2 of the applicator.
• the force exerted by the sleeve 8 on the stop 11, causes the convex curvature of the rods 1 which form the aforementioned corolla, which rods exert a slight weight on the soft parts of the pelvis, sufficient to separate them from the head of the fetus and facilitate its descent in removing obstacles; simultaneously with obtaining said convex curvature of the stems 1, due to its solidarity with the free ends of the stems 1 of the corolla, the reticulated structure tightens around the fetal head around which it forms an atraumatic grasping net. The expulsion is then carried out by acting on the pull handle 9.
• the adjustable convection of the rods 1, the free ends of which can advantageously be spatulated opens the passage of the head of the fetus in its descent, by isolating it from the soft parts of the pelvis, thus avoiding any friction; the flexible material used to produce the crosslinked structure 1 and the distribution of the pressure forces over a surface area of the skull of the fetus larger than the expulsion devices of the prior art allowed, ensures better atraumatic grip.
• the small thickness of the rods 1 and their advantageously spatulated ends, as well as their ease of sliding thanks to the provision of an appropriate coating allow easy introduction into the space around the fetal head at the level of the pelvic excavation.
• the extractor device according to the present invention also has the advantage, due to its design, of being able to be manufactured on an industrial scale at a relatively low cost price, which makes it possible to design the "applicator" part of the apparatus as being a single-use instrument, the traction member being, for its part, reusable.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Gynecology & Obstetrics (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Molecular Biology (AREA)
• Reproductive Health (AREA)
• Engineering & Computer Science (AREA)
• Pregnancy & Childbirth (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Orthopedics, Nursing, And Contraception (AREA)
• Surgical Instruments (AREA)

Priority Applications (1)

Applications Claiming Priority (2)

Publications (2)

Family

ID=9366638

Family Applications (1)

Country Status (8)

Families Citing this family (20)

Family Cites Families (10)

• 1988
  • 1988-05-26 FR FR8807004A patent/FR2631812A1/fr not_active Withdrawn
• 1989
  • 1989-05-26 WO PCT/FR1989/000252 patent/WO1989011253A1/fr active IP Right Grant
  • 1989-05-26 DE DE68911917T patent/DE68911917T2/de not_active Expired - Fee Related
  • 1989-05-26 JP JP1506156A patent/JPH03505409A/ja active Pending
  • 1989-05-26 EP EP89906376A patent/EP0416004B1/de not_active Expired - Lifetime
  • 1989-05-26 AU AU37388/89A patent/AU3738889A/en not_active Abandoned
  • 1989-05-26 US US07/635,538 patent/US5207687A/en not_active Expired - Fee Related
• 1990
  • 1990-11-26 OA OA59902A patent/OA09273A/xx unknown

Non-Patent Citations (1)

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